Prognostic role of pre-diagnostic circulating inflammatory biomarkers in breast cancer survival: evidence from the EPIC cohort study

Background: Inflammation influences tumour progression and cancer prognosis, but its role preceding breast cancer (BC) and its prognostic implications remain inconclusive. Methods: We studied pre-diagnostic plasma inflammatory biomarkers in 1538 women with BC from the EPIC study. Cox proportional hazards models assessed their relationship with all-cause and BC-specific mortality, adjusting for tumour characteristics and lifestyle factors. Results: Over a 7-year follow-up after diagnosis, 229 women died, 163 from BC. Elevated IL-6 levels were associated with increased all-cause mortality risk (HR1-SD 1.25, 95% CI 1.07–1.47). Among postmenopausal, IL-6 was associated with higher all-cause (HR1-SD 1.41, 95% CI 1.18–1.69) and BC-specific mortality (HR1-SD 1.31, 95% CI 1.03–1.66), (PHeterogeneity (pre/postmenopausal) < 0.05 for both), while IL-10 and TNFα were associated with all-cause mortality only (HR1-SD 1.19, 95% CI 1.02–1.40 and HR1-SD 1.28, 95% CI 1.06–1.56). Among ER+PR+, IL-10 was associated with all-cause and BC-specific mortality (HR1-SD 1.35, 95% CI 1.10–1.65 and HR1-SD 1.42 95% CI 1.08–1.86), while TNF-α was associated with all-cause mortality in HER2- (HR1-SD 1.31, 95% CI 1.07–1.61). An inflammatory score predicted higher all-cause mortality, especially in postmenopausal women (HR1-SD 1.30, 95% CI 1.07–1.58). Conclusions: Higher pre-diagnosis IL-6 levels suggest poorer long-term survival among BC survivors. In postmenopausal survivors, elevated IL-6, IL-10, and TNFα and inflammatory scores seem to predict all-cause mortality

Sadomasochism as aesthetic sexuality: a cultural history from the late eighteenth century to the present

© 2010 Dr. Romana Rosalie ByrneFoucault’s ars erotica, one of the most enigmatic concepts in history-of-sexuality studies, has been largely overshadowed by the examination of scientia sexualis and its creation: sexuality constructed as a natural, inborn and permanent function of the body subject to acquired or congenital pathologies. With sexuality, a truth to be discovered and analysed, sexual acts and desires became involuntary manifestations of a fixed biological cause. Foucault argues that only scientia sexualis has operated in modern Western culture whilst ars erotica belongs to Eastern and ancient societies, although in his late essays he suggests that invoking ‘sex as aesthetics’ may be a useful political strategy for marginalised sexualities. Ars erotica, then, is framed as preceding sexuality and as a possible replacement for it. In this thesis, I suggest that modern Western culture has indeed witnessed a form of ars erotica, encompassed in what I term ‘aesthetic sexuality’, which I argue has existed since the eighteenth century. To argue for the existence of aesthetic sexuality, I show how sexuality is constructed as having aesthetic value, a quality that marks this experience as a form of art. Value and meaning are located within sexual practice and pleasure rather than in their underlying cause; sexuality’s raison d’être is tied to its aesthetic value, at surface level rather than beneath it. Aesthetic sexuality is a product of choice, a deliberate strategy of self-creation as well as a mode of social communication, and therefore can be chosen and cultivated by potentially any individual on the basis of its intended aesthetic value. I suggest that, in contrast with the legal, medical and psychiatric discourses and practices that composed the scientia sexualis, aesthetic sexuality is founded upon discourses pertaining to aesthetic theory and philosophy. I construct a cultural history of aesthetic sexuality using the case study of sadomasochism. Each chapter advances my argument by demonstrating the evolving aesthetic value of sadomasochism—the different ways in which the practice has been constructed as art—and showing how different aspects of aesthetic sexuality have been emphasised in different historical periods. I begin this cultural history by examining novels by the Marquis de Sade through the aesthetic philosophy of Kant, Shaftesbury, Hutcheson, Hume and Burke, before employing the aestheticism of Walter Pater to discuss the sadomasochistic poetry of Algernon Charles Swinburne and the novel Torture Garden by Octave Mirbeau. I then provide an exposition of Nietzsche’s aesthetics in order to show their influence on constructions of sadomasochism by Bataille, Réage and de Berg. The aesthetics of Baudrillard, Foucault, Jameson and Butler are then used to examine American political and pornographic writing from 1981 to the early twenty-first century. I conclude this thesis by investigating what the model of aesthetic sexuality developed in the preceding chapters reveals about the most conspicuous articulations of sadomasochism in popular culture today, that is, in mainstream fashion and the subcultural forms defined against it. These particular constructions of sadomasochism, and the aesthetics that inform them, have been selected as those that contribute most significantly to the history of aesthetic sexuality